Three health care questions

Sorry I'm late to the party on this one, Russ...

Regarding question #3, as I first heard it:

"As the price of anything approaches zero, demand trends toward infinity."

Or, as I've seen it written subsequently:

"As price approaches zero, demand approaches infinity."

(2) Why is the fact that “every other industrial nation provide universal health care coverage” considered evidence for its desirability?

I think that if:
(A) you find yourself a lone example of certain policy when everyone else has adopted a different policy,
and
(B) you assume that everyone (including yourself) are reasonably rational actors and none with absolute grasp of the truth,
then
(C) simple Bayesian statistics clearly justifies increasing one's prior estimate of the desirability of the policy everyone else is following.

Of course, we can't answer analytically how much it should increase one's prior estimate. But it seems uncontroversial that it should be increased.

Prof R,

When you finish your work on the financial crisis, I wonder if you would consider embarking upon a similar work on health care. It seems like almost nothing that anybody says on the matter is true, and much of it doesn't even make any sense.

Isn't one Quixotic quest to save a dead ideology enough... give him a break?

1: Private insurance cost are going up faster then Medicare cost.
Why would we want increase the use of private insurance when it's been disastrous?

2: Hmmm.... because it works fine for far less??? Why does the lack of any evidence AT ALL for a private systems success still make some believe such a thing would be great?

3: When as much as 30% of our cost are administrative this claim is presumptuous on your part. But indeed cost ARE hidden in the favor of subsidies to private insurance. If they were straight forward such as a tax we'd demand quality and cost containment.... Again it works IN EVERY OTHER country. The real world evidence answers your question.. prove it inconsequential. Why do some people insist that markets will make renal dialysis and kidney transplant cheap and available too everyone?

And finally because Hayek said so!

"Nor is there any reason why the state should not assist the individuals in providing for the common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance- where, in short, we deal with genuinely insurable risks- the case for the state's helping to organize a comprehensive system of social insurance is very strong."

F.A. Hayek

These 3 questions and more are answered at http://www.anthonyworlando.com/2009/07/26/less-... and http://www.anthonyworlando.com/2009/08/22/getti...

Maybe I'm here to take a beating but:
1.I think this is a clear minimalizing of the problem at hand in order to argue your side of the issue. While I do think there are problems with the future of Medicare, this is certainly not limited to the fiscal disaster of Medicare. The proportion of our economy that is consumed by health care continues to grow with faster than inflation. This is not sustainable if we want to compete in the future.
Why increase the federal governments role? Mostly because it seems to be operating most efficiently. Comparing Medicare to Medicare Advantage, which is the closest thing to comparing apples to apples, it is estimated that the privatized Medicare Advantage is 14% more expensive that government run Medicare. (http://www.kaiserhealthnews.org/Stories/2009/Se...)
This just seems like the most direct route to a solution, but this is far greater problem than just Medicare. The training of doctors is getting so expensive that it has driven many to more high paying specialties as opposed to general practitioners, which are sorely needed. The current practice of insurance companies to rescind high cost patients is a travesty. The fact that we have defacto, immensely inefficient, universal coverage (ERs cannot turn anyone away) means that we only deal with problems once they’re big and expensive (which costs us all, either in higher taxes or higher premiums) needs to be dealt with. Both sides are barely nibbling at these issues, but many Republican lawmakers are now starting to refuse we even have a problem. I just ask for honest debate.

2.That is not what makes it desirable. The fact that every other country provides national healthcare, at a cheaper rate, with better outcomes is what makes it desirable. In our system, the results are very good if you can buy into the system, but can be very poor if you cannot. People are looking for solutions that are good for all, not just those with money.

3. I think the ‘Whole Foods’ model of high deductable, coverage for catastrophic care, and increased medical savings accounts are a good starting point for those with money and the sophistication to understand their own diagnosis. The problem is, the high deductable model falls apart with the poor because it causes them to forgo diagnosis/treatment and the uneducated because of the information problem between the doctor and patient. I haven’t heard a viable alternative for some type of public program/voucher program, which would likely increase taxes on higher earners.

"and the sophistication to understand their own diagnosis. The problem is, the high deductible model falls apart with the poor because it causes them to forgo diagnosis/treatment and the uneducated because of the information problem between the doctor and patient."

And this is whose responsibility??? Being poor is not an excuse for ignorance. This is our problem, the slow creeping up of the welfare state is creating a worthless herd of sheep. If I'm too poor to afford health care, I'll make damn sure to take as good of care of myself as possible. If don't have $ but make the decision to have a child I'll save money to pay for it, not expect someone else to. The welfare state only cheapens the value of our success and our accomplishments. If you want health insurance, join the Reserves, tricare reserve select. Now if the Government wanted to offer tricare reserve select to the nation I wouldn't have a problem with that. Monthly premium, based on whether you want 80/20 or 90/10 cost sharing and an out of pocket cap. People don't appreciate or respect what they don't work or pay for. I have tricare prime, which is free, and if my child coughs I say take her to the DR, why? Because it "won't cost me a thing" but the $ has to come from somewhere......but subconsciously it is there, whether I like it or not...
Grow up, make good decisions, take care or yourself and your family. Count on friends and families before you look for a handout and don't forget to work hard but remember family comes first. We have absolutely destroyed the fabric of our society, or at least most of you have.

"not limited to the fiscal disaster of Medicare. The proportion of our economy that is consumed by health care continues to grow with faster than inflation."

Right. The common proximate cause is growing health care costs. But the financing scheme of Medicare is a MAJOR reason for those growing costs.


"The current practice of insurance companies to rescind high cost patients is a travesty."

The purpose of a market is for two parties to come to a mutually beneficial agreement. I buy insurance because I think the coverage benefits me, and the insurance company thinks the premium benefits them. If EITHER one of us disagrees, then it is RIGHT for either one of us to veto the agreement. It is no more a travesty for an insurance company to not sell a product at a loss, than it is for you refuse to direct your charitable spending toward the insurance company.

If there is a travesty, it is in the small (<5% by the AMA's accounting) number of cases where insurance companies do not live up to their agreements.

"we only deal with problems once they’re big and expensive (which costs us all, either in higher taxes or higher premiums)"

The excess cost is probably not as much as you think, and possibly nonexistent. Screening and preventive medicine costs money, and most of that money is spent, by definition, on healthy people who ultimately will get no benefit (because they will not developed the diseases trying to be prevented). A minority of studies show a cost benefit to society. Most do not. Of course, preventive medicine, excluding the cost, is valuable. Only the individual paying for it can determine if it is worth the cost.

"many Republican lawmakers are now starting to refuse we even have a problem. "

I don't follow lawmakers very closely, so I can't refute this, but can you name some? In my passive exposure, I have not found anyone denying a problem.

"The fact that every other country provides national healthcare...with better outcomes"

That is false. VERY false. I know why you repeat the falsehood (I don't accuse you of bad intent). If you want me to explain why, we can start by you telling me why you believe that to be true.

"high deductable, coverage for catastrophic care, and increased medical savings accounts are a good starting point for those with money"

Just the opposite is true. Those with a lot of money probably don't need any insurance at all, they can just pay. HSAs are PARTICULARLY good for those without much money, the vast majority of whom are young and healthy.


"the sophistication to understand their own diagnosis"

Knowledge is always good, but this is not a necessity for health care consumption. That's why you pay someone with 11-16 years of medical education to help you with that. Most people know as little about electronics, automobiles, housing construction, food processing, etc. but somehow that isn't a problem.


"high deductable model falls apart with the poor because it causes them to forgo diagnosis/treatment"

Again, just the opposite is true. It instead helps the poor precisely because it gives them the choice (rather than "causes" them to forgo) of how and whether to obtain diagnosis and treatment. That mere fact of choice and resulting behaviors, when spread across a large market, results in lower prices. Lower prices help the poor disproportionately.


"public program/voucher program, which would likely increase taxes on higher earners"

What is worse, is that it would cause health care costs to be elevated. What effect do you think that has on the poor?

"If there is a travesty, it is in the small (<5% by the AMA's accounting) number of cases where insurance companies do not live up to their agreements."

The analysis I've seen says that it's only 0.5% of people on insurance have had it rescinded, but 100% of them are those with very expensive conditions. In a given year, only about 1% of people on insurance have these really costly diseases. So it can be that 50% of the people that really need the insurance are the ones that are cut. http://montclairsoci.blogspot.com/2009/08/resci... (there's another article I read I can't find, but says basically the same thing, more clearly, if I find again I will post.). Basically, insurance companies intentionally made applications tough enough, that if something really expensive came up, they could drop you (Congressional testimony of Breast Cancer patient dropped because of 'preexisting condition' which was being treated for acne).

The best example I heard of Republicans was from McCain (Presidential candidate) and McConnell (Senate Minority Leader) here:
http://www.slate.com/id/2226793/

"That is false. VERY false. I know why you repeat the falsehood (I don't accuse you of bad intent). If you want me to explain why, we can start by you telling me why you believe that to be true."

Very simply stated things like (1) delivery mortality and (2) life expectancy (somewhat related as high (1) leads to lowering of (2)). I think the outcomes are great if you can afford to get into the system. My concern is with those without.

Information problem described well on NPR's Planet Money (Episode #80) comparing a doctor to a car mechanic since we usually don't know how to fix a car ourselves. Hard to judge who is fair, whether or not we're getting ripped off, etc...

"It instead helps the poor precisely because it gives them the choice (rather than "causes" them to forgo) of how and whether to obtain diagnosis and treatment."

Not to once again promote Planet Money, but recent episode #87 tackled some solutions to current model where there is no incentive to not use you health insurance (compares it to an all you can eat buffet where you take things even if you don't end up eating it). Studies have shown that the high deductible model does actually lead to the poor delaying care (mentioned in episode).

"What is worse, is that it would cause health care costs to be elevated. What effect do you think that has on the poor?"

Why is this necessarily true? The public option would definitely allow opportunities to control costs. As much press as the 'death panels' has received, the actual proposal of researching best care would definitely help in cases like prescribing generic when found to be equal to expensive patented drugs, establish when surgery is necessary/effective, establish standards of care to help weed out unnecessary malpractice suits, etc... I don't think these should be necessarily set in stone, due to patient variability, but they should offer a starting point.

And please don't give me the government bureaucrat in charge of your healthcare argument. There's already a bureaucrat, he just works for the insurance company.

"Studies have shown that the high deductible model does actually lead to the poor delaying care"

And again...whose responsibility is that? I'm taking care of myself and my family, do I have to hold the "poor" persons hand at the DR as well? You can't regulate a persons personal decision, it is purely up to them, and if they make the wrong decision....shit happens. I go into combat everyday, if I make the wrong decision and something "bad" happens, am I going to blame someone else????

Infant mortality statistics reveal little about relative effectivenes of health care. Measurement of infant mortality varies considerably from nation to nation. As the Statistics Division of the United Nations points out:

"Another factor that limits international comparability is the practice of some countries or areas of not including in infant-death statistics infants who were born alive but died before the registration of the birth or within the first 24 hours of life."

That is true. But it only means that claims about infant mortality are suspect. There are better numbers that researchers use based upon birth weight. And if you restrict comparisons to countries with more accurate reporting, you can get a better picture.

It was recently discovered, and published in the pediatric literature, that premature birth is the leading risk factor for infant mortality in the US (previously it was thought to be birth defects). It also appears that the US has a much higher prematurity rate than other western countries. Combining those two, it should not be surprising if US infant mortality rates are higher than at least some European countries.

But it has not been shown that prematurity rates are a measure of health care quality. It is claimed, but far from established, that it is a result of access to prenatal care. The correlations suggest it could be genetic or cultural--related to age, genetics, and lifestyle of the mother. In particular, there is evidence that even when free prenatal care is made available, high risk mothers do not use it.

But we DO have data comparing survival rates of premature births in the US to Canada. That likely IS a measure of health care quality. The US premature birth survival rates are significantly higher than those in Canada. Neonatology in the US is truly a shining star.

Health care quality comparisons are easily misleading because measures of HEALTH are much more dependent upon factors other than HEALTH CARE. Advocates of coercive monopoly deliberately present uncontrolled statistics, even when controlled ones are available, in order to mislead the public.

The truth is, even if you were to eliminate all health care in all countries, many measures of health like life expectancy, would not change much. Health care is a service we apply at the margins--but those margins are, obviously, extremely valuable to most of us.

"So it can be that 50% of the people that really need the insurance are the ones that are cut."

"Can" strongly depends upon your definitions. It is impossible, in isolation, to defend the complex rules and claim denials and delays that occur. However that is a function of placing cost control in the hands of a third party. As such, it is not unique to private carriers--Medicare has a higher claim denial rate than any private carrier. Just as the decline in Medicare solvency is dependent upon Medicare claim denials, so private insurance premiums are as well. The lower denial rate of private insurers, as well as the higher reimbursements, and profitability is likely due in large part to the greater investment private insurers place in the claims reimbursement process (oddly denigrated by some Medicare defenders as excess "overhead").

Where should cost control be? With the consumer. With most consumption, consumers get to keep whatever money they save. They get to make comparative choices between different types of consumption. The result is that most consumer goods, particularly those dependent upon technology, actually decline in price while simultaneously providing for a great variety of consumer needs. We have not seen much of that effect with health care.


"The best example I heard of Republicans was"

Well then you nicely prove yourself wrong. Not only did McConnell and McCain in that article not "refuse we even have a problem", they offered possible solutions to the problems. Hopefully now you'll correct yourself, and not spread that falsehood anymore.


"Very simply stated things like (1) delivery mortality and (2) life expectancy"

Yes, those are 2 of the 3 things most commonly incorrectly cited to assert that US health care quality is inferior. Both statistics (I assume) are true. Neither is a measure of health care quality.

In almost every case, when you control those numbers to improve their reflection on health care quality, the US comes out on top. For instance, instead of simply looking at overall life expectancy, how about the life expectancy of Asian men versus Asian-American men? Europeans versus European-Americans? Africans versus African-Americans? How about excluding fatal trauma, and just looking at those who live long enough to get health care? How about comparing survival of Europeans with cancer to Americans with cancer?

We know the biggest risk factor for infant mortality in the West is premature birth. The US has a much higher prematurity rate than Europe, but not if you just look at European Americans. To measure the effect of health care quality on that problem, how about comparing survival rate of premature births in the US versus Canada?

In all of those things, and more, the US is unsurpassed. Going purely by available data, the general quality of health care in the US is truly incomparable. That is not to say Americans are healthier than any other people, but the health of individuals is more dependent upon things other than health care quality.


"Studies have shown that the high deductible model does actually lead to the poor delaying care"

The odd thing is that somebody would waste their time and money to study this. Of course, if people have a choice between A and B, they are likely to choose A less often than if their only choice is A.

Those people spent their resources on other things, presumably because they valued those things more. As such, it is a reflection of an IMPROVEMENT in their lives. Arguing that forcing people into certain consumption decisions is better for them than the decisions they make for themselves is something that can only be argued from the values of someone other than the decision maker in question.


"The public option would definitely allow opportunities to control costs."

That really doesn't make any sense. If you think a government supported institution would put competitive pressures on the biggest local company with a 70% regional market share, what do you think it would do to the many smaller companies that are trying to legitimately compete?

And of course why is it, in general, that competition is good? It is because it creates an incentive for innovations in efficiency. But the public option is all about creating an entity that can be MORE inefficient than its private competitor precisely because of its unfair unique government advantages. If that weren't the case, you wouldn't need a government option--someone who thinks the way the President does would just start another private company.

If there is a problem with competition (and I agree there is), the correct solution is to remove that problem so that competition is easier. Not to create an impossibly advantaged and costly competitor that nobody would waste their time creating a company to oppose.

It really is an absurd idea. Consider where it will lead. TVs are too expensive, so we'll create an advantaged government TV company. Mortgages are too expensive, so we'll create a governm...oh wait, we did do that. Worked out great too.

There is no proposal that you named that can control costs as much as simply encouraging consumers to shop and negotiate. That single effect leads to the creation of all kinds of information sources to help people make the best decisions for them.

As far as standards of care, trust me, those exist, and there is very vibrant and healthy intellectual discourse in all fields of medicine with huge bias towards evidence-based diagnosis and treatment. The imposition of politicized government-coerced centralized standards into that arena WILL be quite damaging to that effort.

"There's already a bureaucrat, he just works for the insurance company."

Interesting. Instead of joining me, and advocating the removal of that bureaucrat, you want instead to just remove his incentive to persuade YOU to join, remove his incentive to avoid tort, give him the incentive to serve the collective instead of you, and give him the power to write the laws to enforce it. Sounds like madness to me.

2. It's evidence for feasibility, not desirability. Many people actually do desire universal health care, to which some small-government advocates have been known to reply that universal health coverage would be an expensive disaster for America. The fact that European countries seem to be able to achieve universal coverage, and spend less on health care than the United States does, is evidence that it is feasible here, too.

"The fact that European countries seem to be able to achieve universal coverage, and spend less on health care than the United States does, is evidence that it is feasible here, too."

A "fact" only defensible by an incomplete accounting of costs and benefits.

A real fact, not mentioned by crusaders for monopoly, is that those socialist nations are experiencing cost growth rates similar to the US. it would seem, then, that they have NOT solved the problem.

But most local markets are dominated by a single company. In Louisiana, BC/BS controls 61% of the market. In Maine, Wellpoint controls 71%. In municipalities, this is usually even worse. There already are private monopolies. I think supports either (1) competition by the government or (2) opening up for interstate competition. My only concern with (2) is that all the companies would flock to industry friendly states and health care would suffer without smart federal regulations. But at least there would be competition.

"There already are private monopolies."

There certainly is legislation that gives unfair competitive advantage to each state's largest insurance companies. That legislation should be repealed so that competition can increase. But (1) 80% market share is not a monopoly (and if it were, I assume true monopoly advocates, like advocates of single-payor, would want it). And (2), that is not the main problem of US health care.

"My only concern with (2) is that all the companies would flock to industry friendly states and health care would suffer without smart federal regulations"

Removing the unconstitutional barrier to interstate commerce would improve health insurance precisely because it would allow companies to avoid bad state-level regulations that require consumers to buy insurance products that they do not want (or buy no insurance at all).

Unconstitutional? It's called the Commerce Clause (That would be Article 1, Section 8, Clause 3 of the US Constitution)? Allows for regulation of interstate trade. http://en.wikipedia.org/wiki/Commerce_Clause
Despite arguments to the contrary, so far court precedent has sided with this interpretation. To change it, you would have to find some activist judges.

Not sure I understand what you are arguing, Darren.

The Commerce Clause gives the U.S. Congress the right to regulate interstate commerce. So Congress could enact legislation to allow companies to avoid state-level regulations. However, in absence of such federal law, the McCarran-Ferguson Act of 1945 specifically allows states to restrict interstate sale of insurance. The only exception to state insurance regulation - at least the only one I'm aware of - is the ERISA Act which allows companies which self-insure their workers to avoid state level regulation.

I think vikingvista is calling for federal legislation which would allow insurance companies the same exemption from state laws that self-insured corporations enjoy.

It seems one of us is unfamiliar with the commerce clause, but I'm not sure that it is me:

"The Congress shall have power...To regulate commerce with foreign nations, and among the several states, and with the Indian tribes"

Unless by "Congress" you think the Founders meant "States". Or, and what is more likely, you think it constitutional for Congress to abrogate its explicit constitutional authorities. If the latter, then maybe we can at least agree that Congress should repeal or amend the McCarran-Ferguson Act to allow interstate commerce of insurance company products in the same way all other interstate commerce is protected from state infringement, by the commerce clause.

Why is the fact that “every other industrial nation provide universal health care coverage” considered evidence for its desirability?

johnnyvenom is right. It's not "industrialized," it's "civilized." Don't you want to be civilized? Aren't you just embarrassed by how uncivilized we are???

The assumptions that go into the particular claim are just staggering when you think about it.

1 That's how government programs always work.

2 Because "everybody knows" that all those countries are superior to us in almost every regard. (personally, I think Europeans look down on us out of resentment)

3 Whatever works.

regarding your second question, I encountered a similar inquiry from a friend who wanted the state to provide healthcare. Of course she phrased it along the lines we all have heard "well every other industrialized (or as often the case they insert 'civilized') nation/economy has it, only we don't." For a while I couldn't come up with an answer, I'm not clever like you folks.

But then it dawned on me how to reply to their stupid example. So when this young lady brought up that same tired meme "every blah blah has it, yet we don't" to hint that because they have it we're either not "civilized" or a true economy. I replied: Well at one time, every nation had a monarchy, yet they never work out well either. Virtually every state had the church as the authority on law and arbitrator on liberties, but they were wrong there as well. It goes along the same lines, if all your friends decided to jump off a bridge, would you be "uncivilized" to decide not to?

1) Because you should never let a good crisis go to waste.

2) Because American Idol is the greatest television show ever - it must be, since so many people watch it.

3) Because proponents of Universal Care place a higher value on perceptions of safety and security than they do on actual safety and security. (Partially answered in my reply to Don's #4)

It doesn't.

It isn't.

Because they don't understand basic economics? Got me on that one.

"Why is the fact that “every other industrial nation provide universal health care coverage” considered evidence for its desirability?"

Whenever discussing this with my British or Canadian friends who think it's disgusting that the US doesn't have universal coverage, I tell them that they really don't want the US to go down that path.

Once the elephant enters the room, their healthcare systems will have to start bearing more of the cost, especially for R&D. Currently, since those countries act as large single customers, they get discounts, and the bulk of the cost of R&D is paid by Americans.

The bulk of R&D is paid for by government ($$) and grad students (time). Significantly more pharma money goes to sales and marketing than to research, and far less to basic research--most of it going to trial testing.

Now, start arguing about cutting the FDA down to size and limiting patent protections... now we'll have something to talk about.

Odd how pharma breakthroughs peaked in the late 80's, about the time that Bayh-Dole's effects kicked in. Same stagnation is setting in w/r/t IT software & services, lock-step with growth in software and business method patents. All those patent-protection dollars are a waste.

So many so-called "free-market" proponents spend so much time denying structural and behavioral phenomena (IOW, spend all their time adoring the platonic abstractions of property and free will, reshaping reality to fit the models, like Lehman Brothers quants constructing their house of cards) that they lose site of the forest for the trees.

Point being, just calling something a "free-market" doesn't make it so. Just like asserting that all the amazing pharma "breakthroughs" of the past decade (*cough*) are because of American resolve to pay the price.

(1) Pharmaceutical companies pay for almost 75% of clinical trials with study costs per drug measured in the hundreds of millions of dollars. Basic research rarely costs anywhere near that much. Clinical trials are the heavy lifting.

(2) It has been widely reported in the literature for years that pharma subsidized studies are biased, thereby reducing the value of the trials, and pharma's incentive to invest in them.

(3) Apparently pharma companies' experience is that sales and marketing more than pays for itself. Otherwise they wouldn't be doing it. Are you suggesting there would be an even greater return if they spent more of that on basic research? Do you know something about the business that they don't?


Device and drug company safety standards are typically higher than the FDA's (due in part, I'm sure, do liability fears), but supplying FDA documentation does constitute additional expense and risk, without benefit. Risk, because some bureaucrat can always cause delays or decide to pursue a political agenda; and no benefit, since there is no liability protection. This cost goes toward the public benefit of false sense of security. That apparently has value to some people.

There may be room for patent reform, but you're likely to get more cost savings by removing the prescription drug classification. If people can freely buy Drano and kerosene over the counter, I see no reason why they shouldn't be trusted to figure out how to properly use atenolol or simvastatin. Everyone is free to hire medical advice. If drug companies could realize OTC profits from the start of their patent protection, they would be less inclined to lobby for extended patent protection. And drug companies can always make their sales to pharmacies contingent upon resale restrictions, if they judge that to be appropriate. Also, drugs would be cheaper to consumers.

Russ: to your three questions
1) The failure of any government program is always due to a lack of funding. Since Medicare is failiing it must be due to a lack of funding so therefore we must expand Medicare so it gets greater funding.
2) The US must provide the same programs and benefits as every other industrialized nation so that we can be just like them. That way we can continue to be the global leader.
3) Paying for something, instead of getting it for "free" will diminish demand for that something. Reducing demand causes government programs to fail. See answer #1 above.

The world is circular, just like their logic.

"Why does the impending fiscal disaster known as Medicare justify increasing the role of the federal government and reducing the role of prices which are the essence of Medicare?"

Because the point is to bring the system to its knees, and this will only accelerate the process.

#1. Because government has the magic wand it can do it without cost to the people.

#2. Because being part of the whole and submerging individuality is the correct way in the socialist world.

#3. Because everyone in the LSDCP knows for certainty that everyone has the perfect "right" to see a doctor, free of personal charge, whenever they choose and for what ever reason.

Don't try and confuse them with reality and facts.

It is important to look at the facts from both sides of the argument. Russ' questions can be answered with the following additional questions. These questions are intended to offer an opposing view so that we consider both sides of this important debate.

1. Why does the current disaster known as US health care still justify the believe in the role of price and the assumption that EMH (efficient market hypothesis) works in health care? In fact, isn't the current state of US health care system strong evidence that EMH does not apply to health care.

Note: I am referring to the "price is always right" part of EMH that failed to apply to health care. Unfortunately, the "no free lunch" part of EMH still hold true and the incorrect price is already bear collectively by society today!

2. Given the fact that “every other industrial nation provide universal health care coverage” why shouldn't it be considered evidence that it could work for us? Should we at least keep an open mind?

3. For the 3rd question on who pays, the experience of other industrial nation that provided universal health care coverage have already demonstrated that cost can be kept under control. In fact, it has been demonstrated by many nations that the cost is half or less in comparison to US in terms of percentage of GDP. Also note the health of the citizens of these other nations are equal or better than US.

Therefore, my question is: Besides a universal health care system, is there any other health care system in used today that have a track record of offering comparable level of cost benefit performance?


Bonus:

Technology advance may be already forcing us down the path of universal health care. I won't spoil the plot. Please listen to the interview of the economist Charlie Wheelan on the pod cast. It is a very interesting pod cast and I was surprised.

http://www.npr.org/blogs/money/2009/08/hear_too...

For those interested in why the price in health care is often distorted, the NPR Planet Money blog is an excellent source. In my opion, it has the best unbiased in-depth examination of various aspects of the US health care system.

http://www.npr.org/blogs/money/health_care/

Final note:

The current financial crisis is a strong warning that we cannot assume price is always right. The assumption that we can simply relie on the role of price to fix our health care system lacksed supporting evidence.

Russ, what do you think?